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目的 :探讨肺癌患者细胞DNA断裂修复能力差异的存在及其临床意义。方法 :博莱霉素 (BLM )体外攻击人培养淋巴细胞 ,计数染色体断裂率 (b/c) ,观察低修复型和正常修复型患者接受放化疗后的反应。结果 :①肺癌患者b/c平均值为 1.0 2±0 .72 ,低修复型患者 5 2 % ,极低修复型患者 37% ;②显示随年龄组升高 ,低修复型显著升高 (P <0 .0 5 ) ;③低修复型患者一年复发转移率 31% ,略高于正常修复型患者 2 3 % ;临床出现毒副反应者中低修复型占 78%。结论 :随年龄增大 ,患者细胞DNA断裂修复能力下降。肺癌发生与细胞DNA修复能力的下降有正相关性。低修复型个体更易复发转移 ,放化疗中较易出现临床毒副反应。修复能力的检测有望成为一项较为实用的个体化治疗生物学指标。
Objective: To explore the existence and clinical significance of the differences in DNA repair ability of lung cancer patients. METHODS: BLM (BLM) challenged human cultured lymphocytes in vitro and the chromosome breakage rate (b/c) was counted. The response of patients with low and normal repairs after radiochemotherapy was observed. Results: 1 The average b/c in patients with lung cancer was 1.0 2±0 .72, 52% in patients with low repair, and 37% in patients with very low repair; 2 showed a significant increase in low-repair type with increasing age group (P <0. 0 5 ) ;3The rate of recurrence and metastasis of low-recovery patients was 31% a year, slightly higher than that of normal prosthetic patients by 2 3%; and low-repair type 78% was found in clinical toxicities. CONCLUSION: With increasing age, the ability of the patient to repair DNA breaks decreased. There is a positive correlation between the occurrence of lung cancer and the decrease of cellular DNA repair capacity. Low-recovery individuals are more likely to relapse and metastasize, and clinical toxicities and side effects are more likely to occur during radiochemotherapy. The detection of repair capacity is expected to become a more practical individualized therapeutic biology index.